Telehealth informed consent

Soma Longevity provides certain services through telehealth, including video consultations, secure messaging, and remote data review. By participating in telehealth services, you acknowledge and agree to the following:

Nature of telehealth services

Telehealth involves the use of electronic communications to enable healthcare services when you and your physician are not in the same physical location. This may include video conferencing, secure messaging, and review of remotely collected biometric and laboratory data.

Telehealth services are intended for non-urgent, planned interactions and are not a substitute for in-person medical evaluation when such care is clinically indicated.

Physician identity, patient identity, and location

Telehealth services are provided by Andrew Roehrig, MD, a physician licensed or otherwise legally authorized to practice in the state where you are physically located at the time medical services are furnished.

At the beginning of a clinical telehealth encounter, you may be asked to verify:

• Your full name and date of birth
• Your current physical location
• A telephone number where you can be reached if the connection fails
• The identity of any other person present
• Emergency contact information when clinically appropriate

You agree to disclose your physical location accurately. If you are located in a jurisdiction where Dr. Roehrig is not authorized to practice, the clinical encounter may be rescheduled, limited to nonclinical administrative communication, or canceled.

Technology, privacy, and patient environment

Soma Longevity uses telehealth and communication platforms selected with reasonable administrative, technical, and physical safeguards intended to protect your health information. However, no electronic communication system can guarantee absolute privacy, security, accuracy, or uninterrupted availability.

Potential risks include:

• Unauthorized access to electronic communications
• Technology or internet failures
• Delays, interruptions, or incomplete transmission of information
• Privacy risks created by your surroundings, personal devices, email account, internet connection, or other individuals who may be present

You are encouraged to participate from a private location, use a secure internet connection, protect access to your devices and accounts, and use headphones when appropriate.

Telehealth encounters may not be photographed, audio-recorded, video-recorded, or otherwise reproduced by either party without the prior agreement of everyone participating, except when recording is required or permitted by law.

Soma Longevity is not responsible for internet outages, device failures, or other technology problems outside its reasonable control. If a connection fails, the encounter may be continued by another appropriate method, rescheduled, or discontinued if safe and effective care cannot be provided.

Limitations of telehealth

Telehealth has inherent limitations compared to in-person care. These may include:

• Inability to perform a physical examination
• Reliance on self-reported or device-generated data
• Potential for incomplete or delayed information
• Clinical decisions are based on the information available at the time of the encounter and may be revised if additional information becomes available.

As a result:

• Certain conditions may not be fully evaluated through telehealth
• You may be advised to seek in-person care for further assessment
• The physician reserves the right to determine whether telehealth is appropriate for a given interaction and may require in-person evaluation or referral when clinically indicated.

Clinical evaluation and prescribing

Completion of an intake questionnaire, submission of laboratory results, or exchange of portal messages does not by itself establish that sufficient information is available to diagnose a condition or prescribe medication safely.

Before making a treatment or prescribing decision, Dr. Roehrig will determine whether the available history, records, laboratory information, telehealth interaction, and other clinical information are adequate for the decision being considered.

Depending on the circumstances, Soma Longevity may:

• Request additional records or laboratory testing
• Require a live video consultation
• Recommend or require an in-person examination
• Decline to prescribe or adjust medication
• Refer you to your primary care provider, an urgent-care facility, an emergency department, or another specialist

Prescribing through telehealth is subject to the same professional standards and clinical judgment that apply to in-person care.

Appropriate use

Telehealth services are appropriate for:

• Review and discussion of laboratory and biometric data
• Preventive health consultations and strategic planning
• Follow-up discussions related to your Soma Blueprint

Telehealth services are not appropriate for:

• Medical emergencies
• New or worsening symptoms requiring immediate evaluation
• Situations requiring physical examination or urgent intervention

Emergency care

If you experience a medical emergency, you must call 911 or seek immediate in-person medical care. Soma Longevity does not provide emergency services or continuous monitoring.

Soma Longevity does not provide continuous monitoring of biometric data and does not review incoming data in real time.

Consent to telehealth services

By proceeding, you acknowledge that:

• You have read and understand this Telehealth Agreement
• You understand the risks and limitations of telehealth
• You consent to receive services through telehealth when appropriate

You may withdraw your consent to telehealth at any time; however, this may limit your ability to participate in certain Soma Longevity services.